温针灸联合中药热奄包对大隐静脉曲张患者术后LEDVT风险的影响

Effect of warming needle moxibustion combined with traditional Chinese medicine Hot Election Bag intervention on the risk of postoperative lower extremity deep vein thrombosis in patients with greater saphenous vein varicosity

目的探讨温针灸联合中药热奄包对大隐静脉曲张(GSVV)患者术后下肢深静脉血栓形成(LEDVT)风险的影响。方法选取2019年12月—2020年12月南阳市某医院收治的93例GSVV患者为研究对象,所有患者均接受GSVV高位结扎剥脱术治疗,根据术后不同干预方案分为对照组(46例)和观察组(47例)。对照组患者接受西医常规护理干预,观察组患者在对照组护理基础上接受温针灸联合中药热奄包干预,2组患者均持续干预2周。比较2组患者康复情况,比较2组患者干预前后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)水平,比较2组患者干预前后股总静脉平均血流速度、最大血流流速、双下肢股总静脉管腔直径,比较2组患者干预期间LEDVT发生情况。结果观察组患者皮下血肿消失时间、溃疡面消失时间、小腿麻木感消退时间均短于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者PT、APTT均长于干预前,且观察组长于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者TT均短于干预前,且观察组短于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者FIB水平均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者股总静脉平均血流速度、最大血流流速均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。干预后,2组患者双下肢股总静脉管腔直径均小于干预前,且观察组小于对照组,差异均有统计学意义(P<0.05)。观察组患者干预期间LEDVT发生率为8.51%,低于对照组的30.43%,差异有统计学意义(P<0.05)。结论温针灸联合中药热奄包干预应用于GSVV患者术后康复中效果确切,能改善患者凝血功能及血流动力学,降低LEDVT发生风险,值得在临床上推广使用。

Objective To investigate the effect of warming needle moxibustion combined with traditional Chinese medicine Hot Election Bag intervention on the risk of postoperative lower extremity deep venous thrombosis(LEDVT)in patients with greater saphenous vein varicosity(GSVV).Methods A total of 93 patients with GSVV admitted to a hospital in Nanyang from December 2019 to December 2020 were selected as the subjects.All patients received high ligation and stripping for GSVV and were assigned to the control group(n=46)and the observation group(n=47)according to different postoperative nursing intervention regimens.The patients in the control group received routine western medicine nursing intervention,and the patients in the observation group warming needle moxibustion in combination with traditional Chinese medicine Hot Election Bag intervention in addition to the routine nursing.Patients in both groups received consecutive interventions for 2 weeks.The rehabilitation of patients in the two groups was compared.The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)levels before and after the intervention were compared between the two groups.The mean blood flow velocity,maximum blood flow velocity,and lumen diameter of common femoral vein of lower limbs before and after intervention were compared between the two groups.The incidence of LEDVT was compared between the two groups.Results The disappearance time of subcutaneous hematoma,ulcer surface and lower leg numbness in the observation group were significantly different from those in the control group(P<0.05).After the intervention,PT and APTT in both groups were longer than those before the intervention,and the observation group was longer than the control group,and the differences were statistically significant(P<0.05).After the intervention,TT in both groups was shorter than those before the intervention,with the observation group shorter than the control group,and the differences were statistically significant(P<0.05).After the intervention,FIB levels in both groups were lower than those before the intervention,with the observation group lower than the control group,and the differences were statistically significant(P<0.05).After the intervention,the mean blood flow velocity and maximum blood flow velocity of the common femoral vein in the two groups were higher than those before the intervention,with the observation group higher than the control group,and the differences were statistically significant(P<0.05).After the intervention,the diameter of the common femoral vein of lower limbs in the two groups was smaller than that before the intervention,with the observation group smaller than the control group,and the differences were statistically significant(P<0.05).The incidence rate of LEDVT in the observation group during the intervention was 8.51%,which was lower than that in the control group(30.43%),and the difference was statistically significant(P<0.05).Conclusion Warming needle moxibustion in combination with traditional Chinese medicine Hot Election Bag plays an effective role in the postoperative rehabilitation of patients with GSVV.It can improve the coagulation parameters and blood flow level and reduce the risk of LEDVT.These advantages justify a wider application of this procedure in clinical practice.